AHRQ Patient Safety Network

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Safety Target

•Device-related Complications (178)

•Diagnostic Errors (282)

•Identification Errors (190)

•Discontinuities, Gaps, and Hand-Off Problems (533)

•Fatigue and Sleep Deprivation (126)

•Medication Safety (1306)

•Medical Complications (440)

•Nonsurgical Procedural Complications (103)

•Surgical Complications (806)

•Transfusion Complications (25)

•Psychological and Social Complications (159)

Origin/Sponsor

•Africa (2)

•Asia (60)

•Australia and New Zealand (125)

•Central and South America (9)

•Europe (529)

•North America (3652)

Resource Types

•Audiovisual (42)

•Award (8)

•Book/Report (153)

•Clinical Guideline (9)

•Journal Article (3576)

•Legislation/Regulation (52)

•Meeting/Conference (16)

•Newsletter/Journal (9)

•Newspaper/Magazine Article (399)

•Press Release/Announcement (11)

•Special or Theme Issue (49)

•Tools/Toolkit (45)

•Web Resource (72)

•Grant (3)

Error Types

•Epidemiology of Errors and Adverse Events (1490)

•Active Errors (720)

•Latent Errors (263)

•Near Miss (87)

Approach to Improving Safety

•Quality Improvement Strategies (989)

•Legal and Policy Approaches (333)

•Error Reporting and Analysis (1503)

•Communication Improvement (1156)

•Human Factors Engineering (568)

•Teamwork (399)

•Specialization of Care (251)

•Logistical Approaches (372)

•Culture of Safety (477)

•Technologic Approaches (752)

•Education and Training (832)

Clinical Areas

•Allied Health Services (15)

•Complementary and Alternative Medicine (1)

Target Audience

•Health Care Providers (3213)

•Health Care Executives and Administrators (3472)

•Non-Health Care Professionals (1507)

•Patients (263)

Setting of Care

•Hospitals (2825)

•Psychiatric Facilities (13)

•Residential Facilities (75)

•Ambulatory Care (398)

•Outpatient Surgery (69)

•Patient Transport (35)

1 - 20 of 4444

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REVIEW

Patient safety and error reduction in surgical pathology.

Nakhleh RE. Arch Pathol Lab Med. 2008;132:181-185.

STUDY

Bridging the communication gap in the operating room with medical team training.

Awad SS, Fagan SP, Bellows C, et al. Am J Surg. 2005;190:770-774.

STUDY

The American College of Surgeons' closed claims study: new insights for improving care.

Griffen FD, Stephens LS, Alexander JB, et al. J Am Coll Surg. 2007;204:561-569.

STUDY

Wrong-side/wrong-site, wrong-procedure, and wrong-patient adverse events: are they preventable?

Seiden SC, Barach P. Arch Surg. 2006;141:931-939.

SPECIAL OR THEME ISSUE

Patient Safety and the Invitational Conference on Contemporary Surgical Quality, Safety and Transparency.

Amer Surg. 2006;72:985-1149

STUDY

Retained surgical items: a problem yet to be solved.

Stawicki SP, Moffatt-Bruce SD, Ahmed HM, et al. J Am Coll Surg. 2013;216:15-22.

STUDY

Impact of resident participation in surgical operations on postoperative outcomes: National Surgical Quality Improvement Program.

Kiran RP, Ahmed Ali U, Coffey JC, Vogel JD, Pokala N, Fazio VW. Ann Surg. 2012;256:469-475.

ORGANIZATIONAL POLICY/GUIDELINES

Recommendations for quality assurance and improvement in surgical and autopsy pathology.

Association of Directors of Anatomic and Surgical Pathology. Hum Pathol. 2006;37:985-988.

STUDY

Medical errors arising from outsourcing laboratory and radiology services.

Chasin BS, Elliott SP, Klotz SA. Am J Med. 2007;120:819.e9-11.

STUDY

Protecting patients from an unsafe system: the etiology and recovery of intraoperative deviations in care.

Hu YY, Arriaga AF, Roth EM, et al. Ann Surg. 2012;256:203-210.

BOOK/REPORT

Annual Benchmarking Report: Malpractice Risks in Surgery.

Cambridge, MA: CRICO/RMF Strategies; 2010.

STUDY

Perioperative patient safety: correct patient, correct surgery, correct side--a multifaceted, cross-organizational, interventional study.

Zohar E, Noga Y, Davidson E, Kantor M, Fredman B. Anesth Analg. 2007;105:443-447.

MULTI-USE WEBSITE

Surgical Care Improvement Project.

National SCIP Partnership, Oklahoma Foundation for Medical Quality, 14000 Quail Springs Parkway, Suite 400, Oklahoma City, OK, 73134.

COMMENTARY

Critical diagnoses (critical values) in anatomic pathology.

Association of Directors of Anatomic and Surgical Pathology. Hum Pathol. 2006;37:982-984.

BOOK/REPORT

Reducing Colorectal Surgical Site Infections.

Oakbrook Terrace, IL: Joint Commission Center for Transforming Health Care. Chicago, IL: American College of Surgeons. November 2012.

STUDY

Medication-error reporting and pharmacy resident experience during implementation of computerized prescriber order entry.

Weant KA, Cook AM, Armitstead JA. Am J Health Syst Pharm. 2007;64:526-530.

COMMENTARY

The lost sponge: patient safety in the operating room.

Grant-Orser A, Davies P, Singh SS. CMAJ. 2012;184:1275-1278.

STUDY

Surgical skill is predicted by the ability to detect errors.

Bann S, Khan M, Datta V, Darzi A. Am J Surg. 2005;189:412-415.

STUDY

Surgical confusions in ophthalmology.

Simon JW, Ngo Y, Khan S, Strogatz D. Arch Ophthalmol. 2007;125:1515-1522.

COMMENTARY

A nurse-led approach to developing and implementing a collaborative count policy.

Norton EK, Micheli AJ, Gedney J, Felkerson TM. AORN J. 2012;95:222-227.

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